Real-time transthoracic vector flow imaging of the heart in pediatric patients

Abstract

In children with congenital heart defects, Doppler ultrasound is the standard, bedside imaging modality. However, precise characterization of blood flow is challenging due to angle-dependent and one-dimensional velocity estimation. Contrast agent free Vector Flow Imaging is a new ultrasound technology that enables angle-independent visualization of the detailed flow field. Two piglets, one with normal cardiac anatomy and one with congenital heart disease comprised of valvular pulmonary stenosis, a dilated main pulmonary artery, and an incomplete atrioventricular canal defect, were imaged transthoracically and epicardially using a BK Ultrasound bk5000 with built-in vector flow imaging and a 5MHz linear probe. Subsequently, two children, one with normal cardiac anatomy and one with congenital heart disease comprised of aortic valve stenosis and coarctation of the aorta were imaged transthoracically. Transthoracic two-dimensional echocardiography and vector flow imaging were readily performed in both animals and were limited only by the geometry of the porcine thorax. In addition, transthoracic vector flow imaging was successfully performed in both children, and abnormal flow secondary to cardiac anomalies was visible. Adequate penetration was obtained to a depth of 6.5 cm. Our group has previously

Left ventricular vortex analysis by high-frame rate blood speckle tracking echocardiography in healthy children and in congenital heart disease

“…High-frame rate Blood speckle tracking (BST) echocardiography is a new technique for the assessment of blood flow. [1] , [2] , [3] , [4] , [5] , [6] , [7] BST may be used to visualize and quantify intra- and extra-cardiac flow patterns, and could improve our understanding of cardiac physiology. Compared to conventional Doppler, high-frame-rate BST is an ultrafast technique which generates up to thousands of frames per second and which is independent of the angle of insonation.…”

“…BST has been technically validated in pediatric patients, but its clinical applications need to be further explored. [3] , [4] , [5] , [6] The aim of the present investigation was to evaluate the presence and characteristics of LV vortices in healthy children and in those with CHD.…”

Towards multi‐modal data fusion for super‐resolution and denoising of 4D‐Flow MRI

“…Since 2000 PC‐MRI has been used to measure time resolved, 4D velocities in a scan process known as “4D‐Flow MRI” 11,12 . Recently, there have been reports of a new doppler technique called vector flow imaging (VFI) to measure volumetric blood flow velocities 13 . The techniques developed in this paper are only applicable to blood velocity quantification using 4D‐Flow MRI.…”

Intracardiac Flow Visualization Using High-Frame Rate Blood Speckle Tracking Echocardiography: Illustrations from infants with Congenital Heart Disease

“…Intracardiac Flow Visualization Using High-Frame Rate Blood Speckle Tracking Echocardiography: Illustrations from infants with Congenital Heart Disease Massimiliano Cantinotti, MD 1,2 ; Pietro Marchese, MD 1,3 Martin Koestenberger, MD4; Raffaele Giordano M.D 5, Giuseppe Santoro M.D. 1; Nadia Assanta, MD 1 ; Shelby Kutty, MD, MS, PhD 6…”

“…In congenital heart disease (CHD) a variety of complex alterations in blood flow pattern occur, and BST echocardiography may enhance their visualization. High-frame rate BST echocardiography has been technically validated in pediatric patients (3), but clinical applications are to be defined (1)(2)(3).…”